Spinal Cord Infarction With Prolonged Femoral Venoarterial Extracorporeal Membrane Oxygenation
Authors' conclusion
An SCI is a serious complication of extended peripheral VA-ECMO support. Its etiology remains uncertain, but the authors' preliminary data suggested that spinal cord edema from hyperperfusion or venous congestion could contribute.
Study context
- Population
- Patients requiring prolonged venoarterial extracorporeal membrane oxygenation (VA-ECMO) at a single university institution
- Participants
- 132 patients
- Outcome
- SCI incidence
Methodological detailssingle-centre, observational
- Single-centre
- Observational
Main finding
As reported in the abstract
Patients with prolonged VA-ECMO who developed spinal cord injury (SCI)
7
5.3%
Median time from ECMO cannulation to SCI, days (range 6-17)
7
Observational data: associations, not effects.
Further findings
Potential mechanisms of SCI
- Unilateral internal iliac artery covered by arterial cannula
- 6/7 86%)
- Median total flow (ECMO + intrinsic CO), L/min
- 8.5
- Indexed flow, LPM/m²
- 4.1
- Median central venous oxygen saturation
- 88%
- ICP measured in one patient, mmHg (suggestive of hyperperfusion and spinal cord edema)
- 30
- No evidence of embolic SCI or extended regional hypoxia or hypocarbia
- Flow into internal iliac shown on imaging in all available patients
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Spinal Cord Infarction With Prolonged Femoral Venoarterial Extracorporeal Membrane Oxygenation. J Cardiothorac Vasc Anesth. Published 5 January 2023. doi:10.
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